Ahmad Noorain, Veerapalli Harish, Lankala Chetan Reddy, Castaneda Everardo E, Aziz Afia, Rockferry Amy G, Hamid Pousette
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2021 Nov 7;13(11):e19325. doi: 10.7759/cureus.19325. eCollection 2021 Nov.
Diabetic nephropathy is becoming a more predominant cause of end-stage renal disease, as the prevalence of diabetes mellitus worldwide is on the rise. In this systematic review, we aimed to define the role of endothelin receptor antagonists, in the prevention and treatment of diabetic nephropathy, in addition to determining their safety. For this review, PubMed, Google Scholar, and Cochrane Library databases, in addition to ClinicalTrials.gov, were searched for publications in the last 20 years. We included 14 studies, seven randomized control trials, and seven post hoc analyses in this paper. Atrasentan decreased albuminuria, reduced blood pressure, and improved lipid profiles with more manageable fluid overload-related adverse events than avosentan and bosentan. Overall, endothelin receptor antagonists, in combination with renin-angiotensin-aldosterone system inhibitors, effectively reduce albuminuria and prevent the progression of diabetic kidney disease. However, more extensive clinical trials still need to be conducted to confirm these relationships and to learn more about the specific factors affecting their efficacy in individual patients.
随着全球糖尿病患病率的上升，糖尿病肾病正成为终末期肾病越来越主要的病因。在这项系统评价中，我们旨在确定内皮素受体拮抗剂在糖尿病肾病预防和治疗中的作用，并确定其安全性。对于本评价，我们检索了PubMed、谷歌学术和考克兰图书馆数据库以及ClinicalTrials.gov，以查找过去20年的相关出版物。本文纳入了14项研究，其中7项随机对照试验和7项事后分析。与阿伏生坦和波生坦相比，阿曲生坦可降低蛋白尿、降低血压、改善血脂谱，且与液体超负荷相关的不良事件更易于控制。总体而言，内皮素受体拮抗剂与肾素-血管紧张素-醛固酮系统抑制剂联合使用，可有效降低蛋白尿并预防糖尿病肾病进展。然而，仍需开展更广泛的临床试验来证实这些关系，并进一步了解影响其在个体患者中疗效的具体因素。
